实验与检验医学
實驗與檢驗醫學
실험여검험의학
EXPERIMENTAL AND LABORATORY MEDICINE
2015年
2期
140-143
,共4页
CBC%LDH%ROC%白血病%淋巴瘤
CBC%LDH%ROC%白血病%淋巴瘤
CBC%LDH%ROC%백혈병%림파류
CBC%LDH%ROC%Leukemia%Lymphoma
目的：探讨血细胞计数(CBC)联合乳酸脱氢酶(LDH)对白血病、淋巴瘤骨髓侵犯早期筛查的临床诊断价值，建立筛查规则。方法收集我院260例白血病、淋巴瘤骨髓侵犯患者初诊或复发时初次CBC、LDH结果，运用受试者工作曲线(ROC)分析白细胞总数(WBC)、血红蛋白(HB)、血小板(PLT)、淋巴细胞绝对值(L#)、淋巴细胞百分比(L%)、中性粒细胞绝对值(N#)、中性粒细胞百分比(N%)、单核细胞绝对值(M#)、单核细胞百分比(M%)及LDH 对白血病、淋巴瘤骨髓侵犯诊断的曲线下面积(AUC)，筛选出具有诊断价值的指标。分析这些指标联合诊断的灵敏度(SE)、特异性(SP)、阳性预测值(PPV)、阴性预测值(NPV)，建立筛查规则。结果增高有诊断价值的指标有WBC、L#、L%、LDH、M#；减低有诊断价值的指标有N%、HB、PLT、N#。建立的CBC+LDH筛查规则如下：WBC≥20×109/L或≤2.7×109/L；HB≤60 g/L；PLT≤55×109/L或≥355×109/L；L#≥3.5×109/L；L%≥52%；M#≥0.7×109/L；LDH≥400U/L；WBC不能分类或分类不全；当WBC≥20×109/L，HB、PLT不减低，L#、L%、PLT不增高，不存在WBC不能分类或分类不全情况，则可排除白血病及淋巴瘤骨髓侵犯的可能性。该筛查规则对白血病、淋巴瘤骨髓侵犯的诊断灵敏度、特异性、阳性预测值、阴性预测值分别为95.4%、62.5%、80.5%、89.3%。结论 CBC+LDH法优于CBC法，可作为白血病、淋巴瘤细胞骨髓侵犯的有效筛查手段。
目的：探討血細胞計數(CBC)聯閤乳痠脫氫酶(LDH)對白血病、淋巴瘤骨髓侵犯早期篩查的臨床診斷價值，建立篩查規則。方法收集我院260例白血病、淋巴瘤骨髓侵犯患者初診或複髮時初次CBC、LDH結果，運用受試者工作麯線(ROC)分析白細胞總數(WBC)、血紅蛋白(HB)、血小闆(PLT)、淋巴細胞絕對值(L#)、淋巴細胞百分比(L%)、中性粒細胞絕對值(N#)、中性粒細胞百分比(N%)、單覈細胞絕對值(M#)、單覈細胞百分比(M%)及LDH 對白血病、淋巴瘤骨髓侵犯診斷的麯線下麵積(AUC)，篩選齣具有診斷價值的指標。分析這些指標聯閤診斷的靈敏度(SE)、特異性(SP)、暘性預測值(PPV)、陰性預測值(NPV)，建立篩查規則。結果增高有診斷價值的指標有WBC、L#、L%、LDH、M#；減低有診斷價值的指標有N%、HB、PLT、N#。建立的CBC+LDH篩查規則如下：WBC≥20×109/L或≤2.7×109/L；HB≤60 g/L；PLT≤55×109/L或≥355×109/L；L#≥3.5×109/L；L%≥52%；M#≥0.7×109/L；LDH≥400U/L；WBC不能分類或分類不全；噹WBC≥20×109/L，HB、PLT不減低，L#、L%、PLT不增高，不存在WBC不能分類或分類不全情況，則可排除白血病及淋巴瘤骨髓侵犯的可能性。該篩查規則對白血病、淋巴瘤骨髓侵犯的診斷靈敏度、特異性、暘性預測值、陰性預測值分彆為95.4%、62.5%、80.5%、89.3%。結論 CBC+LDH法優于CBC法，可作為白血病、淋巴瘤細胞骨髓侵犯的有效篩查手段。
목적：탐토혈세포계수(CBC)연합유산탈경매(LDH)대백혈병、림파류골수침범조기사사적림상진단개치，건립사사규칙。방법수집아원260례백혈병、림파류골수침범환자초진혹복발시초차CBC、LDH결과，운용수시자공작곡선(ROC)분석백세포총수(WBC)、혈홍단백(HB)、혈소판(PLT)、림파세포절대치(L#)、림파세포백분비(L%)、중성립세포절대치(N#)、중성립세포백분비(N%)、단핵세포절대치(M#)、단핵세포백분비(M%)급LDH 대백혈병、림파류골수침범진단적곡선하면적(AUC)，사선출구유진단개치적지표。분석저사지표연합진단적령민도(SE)、특이성(SP)、양성예측치(PPV)、음성예측치(NPV)，건립사사규칙。결과증고유진단개치적지표유WBC、L#、L%、LDH、M#；감저유진단개치적지표유N%、HB、PLT、N#。건립적CBC+LDH사사규칙여하：WBC≥20×109/L혹≤2.7×109/L；HB≤60 g/L；PLT≤55×109/L혹≥355×109/L；L#≥3.5×109/L；L%≥52%；M#≥0.7×109/L；LDH≥400U/L；WBC불능분류혹분류불전；당WBC≥20×109/L，HB、PLT불감저，L#、L%、PLT불증고，불존재WBC불능분류혹분류불전정황，칙가배제백혈병급림파류골수침범적가능성。해사사규칙대백혈병、림파류골수침범적진단령민도、특이성、양성예측치、음성예측치분별위95.4%、62.5%、80.5%、89.3%。결론 CBC+LDH법우우CBC법，가작위백혈병、림파류세포골수침범적유효사사수단。
Objective To explore the clinic diagnostic value of complete blood count (CBC) and lactate dehydrogenase (LDH) in early screening of leukemia and lymphoma with bone marrow involvement and establish screening rules. Methods The database of CBC and LDH was collected from 260 patients with leukemia and lymphoma of bone marrow involvement at newly diagnosed or recurrence before treated in our hospital. The receiver operating characteristic curve (ROC) was used to analysis the total number of white blood cells (WBC), hemoglobin(Hb), platelet (PLT), absolute value of lymphocyte (L#), the percentage of lymphocytes (L%), absolute neutrophil count (N#), neutrophil percentage (N%), absolute value of mononuclear cells (M#), the percentage of mononu-clear cells (M%) and LDH, and the area under the curve (AUC) was used to screen the valuable diagnostic index for leukemia, lymphoma with bone marrow involvement. The screening rules were found by analyzing the sensitivity (SE), specificity (SP), posi-tive predictive value (PPV), negative predictive value (NPV) of the combined diagnose using these indicators. Results The in-creased diagnostic indicators were WBC, L#, L%, LDH, M#, and the decreased were HB, PLT, N#, N%. The CBC+LDH screening rules were as follows:WBC≥20×109/L or ≤2.7×109/L; HB≤60g/L; PLT≤55×109/L or ≥355×109/L; L# ≥3.5×109/L; L%≥52%;M#≥0.7×109/L; LDH≥400U/L; WBC could not be classified or classification was not complete; when WBC≥20×109/L, HB, PLT did not reduce and L#, L%, PLT did not increase, while there was no WBC could not be classified or classification was not com-plete, then the possibility of leukemia and lymphoma with bone marrow involvement could be ruled out. The sensitivity, specificity, PPV, and NPV of this screening rules in diagnosing leukemia and lymphoma bone marrow involvement were 95.4%, 62.5%, 80.5%, 89.3%, respectively. Conclusion The CBC+LDH method can be as an effective screening in diagnosing leukemia and lym-phoma with bone marrow invasion better than CBC.
